Basic Information
| Provider Information | |||||||||
| NPI: | 1811347511 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGAFONOFF | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | SLAVA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4777 E GALBRAITH RD | ||||||||
| Address2: | DEPARTMENT OF SURGERY | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452362725 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 OLD YORK RD STE 2B | ||||||||
| Address2: | |||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154812222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2016 | ||||||||
| LastUpdateDate: | 01/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OS021193 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.